Rough Draft of introduction of ” The Cultural Politics of Healthy Obesity”.

In the last 30 years average BMI and the prevalence of obesity (definied as above a BMI of 30 or the 95th percentile for children) has risen worldwide (Wright and Harwood 2009). Culturally we have reacted to this phenomenon with acceptance yet alarm (Wright and Harwood; Guthman 2010); constructing obesity as an epidemic (Moffat 2010) and calling it one of the greatest public health concerns of our time (Guthman 2010). This social stance has driven the science of obesity from unbiased inquiry to that of stigma and fear. This stigma, which has existed historically in Western societies (Gillman 2009) and is growing worldwide (Brewis et al. 2010), is evident in the way obesity is approached and studied in the medical literature. As stigma is culturally constructed, obesity as a phenomenon is best characterized as biocultural; a term with describes an approach which attempts to define the space in which biology and culture inform one another dialectically (Ritenbaugh; Goodman and Leatherman).  With this framework, we will examine what has recently surfaced in the biomedical literature as healthy obesity, metabolically healthy obese (MHO) and the “obesity paradox” (refs).  We argue that this phenomenon cannot be considered without understanding the cultural politics of obesity as it has developed in the past few decades, which has precluded researchers from questioning how we define, clinically treat, and culturally view obesity as a diseased state.

Since 2006, a significant amount of academic literature has been published endorsing the idea of healthy obesity (Denis and Obin 2012). This contention suggests that up to 30% of individuals are categorized, according to BMI cut-offs, as obese, yet they do not possess the major health risks that are associated with an excess of fat (Primeau et al 2010). This group has been even further defined as the metabolically healthy obese (MHO), made up of individuals who are “enigmatically immune” to obesity related disease (Bluher 2012, pg. #?). Obesity research has also uncovered further inconsistencies with the discovery of the obesity paradox, a phenomenon where excess fat, in some circumstances, may be advantageous in mitigating health risk (Amundson, Djurkovic and Matwiyoff 2010). These inconsistencies are not the product of biological mis-steps but are born, as we argue, of the cultural politics of obesity.

These inconsistencies begin with the way obesity is defined, and also include the way in which it is studied and measured. As such, body mass index (BMI) will be examined, and its perpetuation as a tool used in obesity studies will be questioned. The concept of the Metabolically Healthy Obese (MHO) will be introduced and challenged as an appropriate interpretation of recent research. The ‘Obesity Paradox’ will also be briefly examined and be criticized with respect to its premise. We will aslso consolidate and validate these several mis-steps as a product of cultural influence and therefore suggest how they remain confusing when tackled solely through a biological lens. A framework will also be proposed – one that emphasizes the life course approach, which may be better equipped to manage the social, cultural and biological aspects of obesity as a chronic condition.

Blog 6- the conference presentation; Dr. Meldrum

For the sixth blog I would like to review a conference presentation that I found particularly effective. There are several ways to accomplish an effective presentation, but I do feel in particular- all good presentations include the telling of good stories. Good science involves good stories; sometimes adventure, and usually a mystery to solve. This talk is certainly embodies that spirit.

Dr. Jeff Meldrum is the speaker I will be focusing on. He is a professor of anthropology specializing in primate locomotion at the Idaho state University. He also has another  quality I find very appealing- He is a hardcore Bigfoot believer! Heres the link below, I hope some of you give it a go, and I will continue on to discuss why this is my submission for what makes a good presentation at a conference.

Presented at the OSS (Oregon Sasquatch Symposium),

I chose this presentation because i was immediately engaged when I first heard it a couple years ago.  I feel that it argues emphatically and obviously for an important point- good presentations are not always so because of their content. I think this point resonates with this presentation as it addresses different anatomical and anthropological approaches to bigfoot.

The set-up for this presentation is effective. The dual screens make it easy to focus centrally on the speaker while still paying some attention to the slides. One of the strongest pieces of Dr. Meldrum’s talk were the slides- they really helped communicate the story he was telling. When he would speak about a remote part of the world, the slides were ordered first as an overhead shot of the area, then some locals, and then usually Dr. Meldrum embedded in some part of the jungle. The slides also were easily comparable from one to the next, often showing an anatomical enfleshed rendering of bigfoot, followed by their footprints. I also liked the fact that he was not confined by the podium and often emerged from between the slides to engage the audience more directly. As this was the case, perhaps a clip-on microphone would have been more effect than the handheld model, maybe this type of expense could be covered in the coming years with generous donations to bigfoot associations around the country. Despite having only one hand to gesture, his use hand signals were in that perfect middle ground in which they were energetic and revealed the passion he had for his work, yet were not so over-board to where they were distracting.

The structure of Dr. Meldrum’s talk also deserves positive attention, especially since he mentions that his time is much shorter than he had planned for. I appreciate that he began his talk by emphasizing that his focus was regarding a specific bigfoot footprint in vietnam. As discussed in the seminar about effective journal writing, was the tendency for the authors to maintain a bit of a mystery as to their main focus. Dr. Meldrum was not guilty of this type of structural error, as he made clear his motivation for speaking that evening quite early. He also very skillfully weaved ethnographic anecdotes, personal anecdotes, evolutionary theory and primate anatomy and locomotion. These were often weaved together rather seamlessly by Dr. Meldrum apparently traveling down unexpected tangents of thought. Regardless of whether they were planned or not, this type of conversational tone I find very effective and entertaining. I believe he also knew his audience well. Although I could not be sure what types of scientists attend the OSS, I must assume they do have more credible scientific backgrounds, with perhaps only a passing interest in large mysterious Apes. Dr. Meldrum accurately assessed his audience as his use of jargon made his points more impactful, yet not to the extent to where I felt he alienated his audience.

His tone was also appropriate for the type of research and investigation on which he was speaking, despite being clearly rushed by the clock. It was even with subtle emphasis. Some people find smooth lecturers often hypnotic and difficult to maintain a connection with, but I find those types of talks soothing and amoung the more easier talks to engage with. An effective benchmark for a speaker is whether you feel after listening to them that you would like to have a conversation with them at a cocktail party- for me, and I suspect many others, Dr. Meldrum succeeds. I think Dr. Meldrum gave an effective talk, to an audience far beyond the attending members of the OSS. He succeeded despite having quite controversial and perhaps unattractive content, a real testament to what can make an effective conference presentation.



Il buono, il brutto, il cattivo

The Good, Bad and Ugly.

In honesty, I have yet to read a journal article that I felt was flawless, or on the other hand useless. There are however, seemingly stark differences between some pieces in a body of literature. These differences might be assumed to result from the wide range of specialities that exist within a given subject- the articles one might find incomplete or irrelevant are embedded in a part of a subject area in which one is unequipped to intellectually engage with.

However, from my time as a graduate student, participating in discussions with other students and profs of all different anthropological backgrounds, I have indeed found that there is good evidence that there are good, bad and ugly articles and that their successes and failures transcend the discipline of their readership.

Ben-Shlomo, Yoav, and Diana Kuh

2002 A Life Course Approach to Chronic Disease Epidemiology: Conceptual Models, Empirical Challenges and Interdisciplinary Perspectives. International Journal of Epidemiology 31(2):285-293.

This paper introduces the reader to ‘the life course approach’ to the epidemiological study of chronic disease. I have found there is a great tendency for articles that outline anthropological theories and frameworks to be frustratingly, and no doubt purposefully, muddy and vague. This mistake in not made in the description of this framework, and is refreshingly specific with examples to illustrate conecpts.

The theoretical approach to the structure of this paper makes the framework easily approachable and understandable. First the framework is established within the current study of epidemiology, as filling a certain need as highlighted by chronic disease. Most disease models focus on the study of pathology in a cross-sectional fashion, rarely accounting for the context in which an individual might develop a disease. The life course approach gets its explanatory power from attempting to bridge the divide between the social factors that influence health, and the biological systems in which they manifest. This approach focuses on risk, not linearly like most other models, but through the concepts of sensitive and critical periods of development, periods in which biological and social insults may be especially impactful in the short and long-term.

The strength of this paper is in its effective integration of somewhat hazy anthropological theory with specific examples. The authors illustrate concepts surrounding biological-social interaction in diseased states with a network of causes; and include 2 other diagrams which force the reader to have an accurate interpretation and conceptualization of the framework.

Finally the authors also pay close attention to context. This is important as the reader wants to know where a paper fits into their interpretations in the literature. Just as the paper began with some historical context, it wraps up by placing this framework in an evolutionary context. I feel this is again important. Evolutionary principles are ingrained in anthropological research, and a commitment to explore them should be more prevalent when it is available. The context of this theoretical approach is also discussed with reference to other frameworks that are already used- how they differ and how they may be used in tandem when tackling certain complex issues in the study of disease. Finally, there is an honest discussion of the limitations and challenges of this framework, namely databases and data collection, which may be a significant hindrance now, but might be later solved with more sophisticated data technologies.

Piperata, Barbara Ann

2008 Forty Days and Forty Nights: A Biocultural Perspective on Postpartum Practices in    the Amazon. Social Science & Medicine 67(7):1094-1103.

This paper researched the postpartum changes of lifestyle in women that belong to a particular community in the amazon. When these women deliver their child, there routines and feeding practices change markedly. At this point, certain cultural stigmas surround certain foods, which the women are not to eat. There contributions around the house also change and their responsibilities to the smooth functioning of the community diminish.  They tend to sit back as other family member take on the extra work. The authors approached this postpartum event and subsequent changes in hopes to address 3 questions- what were the ideas surrounding the consumption of certain foods over others; what type of commitment did these women have towards this practice; and whether this restricted diet and altered community chore commitment had a negative impact on their ability to breastfeed their child.

Their findings suggested that these practices were quite varied amoung the different communities and that this tradition focused on limiting the types of foods, ie. Certain sea creatures, that may cause illness in the mother. The authors also found that some women, those closer to the nearest town, did not subscribe to these practices to the same extent as other women, and finally that these women did a reduced caloric load, but this was offset by their reduced caloric expenditure.

I found this article unsatisfying because it did not do what I believe a good anthropological paper should- convince me that I should care. I understand that they are anthropologists who would move to the edge of their seat when provided the opportunity to learn about postpartum practices of rural women of the amazon. But they are likely in the minority. I feel the importance of studies like this is to elucidate certain anthropological principles that are larger than the population they are studying. For instance-

Why 40 days and nights? What is the significance of this amount of time? Are there other communities around the world that also commit to cultural practices for this period of time. Could they be compared and contrasted to reveal certain underlying principles?

How were these traditions about food choices transmitted from generation to generation? Is this type of knowledge transmission evident in other facets of the Amazonian culture? Is there any evidence that these practices have changed over time, and if this change is reflective of important qualities of other populations in the amazon?

Also, lets suppose that the authors did find that the reduction of calories expended during the 40 days was not offset by the reduction in calories ingested, what then?  Were they going to let the women in on that in hopes that it would change their postpartum choices?

Why were they spending all this time studying the postpartum practices of amazon women other than discovering the postpartum practices of amazon women?

There is also very little discussion about why this type of practice might have developed, and what this may suggest about the social subtleties in this community. Perhaps there is some interesting psychological factors that have allowed this practice to take hold in these communities- perhaps these women gain a type of satisfaction by having the rest of their family wait on them, that has a positive impact on their child?

Studies like this have a tremendous value in anthropology. But they must be framed in such a manner as to a least engage slightly with more universal principles. In this way this paper failed- in execution and more importantly, in imagination.